Articles: palliative-care.
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Ulus Travma Acil Cer · Nov 2020
Does a selective surgical approach to malignant bowel obstruction help in palliative care patients?
Malignant bowel obstruction (MBO) is a condition secondary to intra-abdominal metastatic spread of advanced-stage tumors. There is no consensus for the treatment approach of MBO. This study aims to present the results of medical treatment and palliative surgery in patients diagnosed with MBO. ⋯ This study revealed that surgical treatment resulted in better outcomes for life quality parameters in highly selected patients with malignant bowel obstruction evaluated by multidisciplinary team, including palliative care.
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Cancer cachexia (CC) is a multifactorial syndrome that is associated with worse outcomes. Several criteria for its diagnosis have been suggested, but notable disparities exist. This study compared different diagnostic criteria for CC in patients with incurable cancer who are in palliative care. ⋯ Our results demonstrate the disparities in existing CC diagnostic criteria and their inability to discriminate intermediate stages. Vigano et al.'s criteria is/was the most effective in predicting the prognosis. The development of new diagnostic criteria to improve CC classification requires future exploration.
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Ketamine has been used as an adjuvant to opioid therapy for the management of refractory cancer pain but the current evidence is insufficient to draw any conclusions regarding its efficacy. We aimed to assess the response to ketamine in patients with refractory cancer pain treated in an oncology palliative care unit. ⋯ These data demonstrated the efficacy and safety of ketamine in a population of patients with refractory cancer pain. The use of more than one coanalgesic was associated with a favorable response to ketamine. Further large and multicentered studies are warranted to confirm these data.
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Coronavirus-2 (COVID-19) is a global pandemic. As of August 21, mortality from COVID-19 has reached almost 200,000 people, with the United States leading the globe in levels of morbidity and mortality. Large volumes of high-acuity patients, particularly those of advanced age and with chronic comorbidities, have significantly increased the need for palliative care resources beyond usual capacity. More specifically, COVID-19 has changed the way we approach patient and family member interactions. ⋯ We describe our rapid and ongoing implementation of TM consultation for our ED patients and discuss lessons learned and recommendations for others considering similar care models.